Short-term CPAP treatment induces a mild increase in inflammatory cells in patients with sleep apnoea syndrome.

Department of Pulmonology, Medical University of Silesia, Katowice, Poland.
Rhinology (Impact Factor: 2.78). 07/2008; 46(2):144-50.
Source: PubMed

ABSTRACT Nasal CPAP has been proven to be an efficient method of treating SAS patients without facial dysmorphism. However, it still remains a matter of debate why it is not universally well tolerated. The AIM OF THE STUDY was to evaluate the influence of initial CPAP treatment on nasal function in SAS patients.
Forty-two patients were consecutively included in a prospective clinical study and divided into the three following groups: 1) SAS subjects (26 patients qualifying for CPAP treatment), 2) First control group (C1) (9 patients with mild or moderate SAS, not willing to be treated with CPAP, AHI > 5 [n/h]), 3) Second control group (C2) (7 healthy subjects, AHI < or = 5). Nasal patency was measured by active anterior rhinomanometry (AAR) at recruitment and after a three-day CPAP treatment. After each AAR nasal lavage was obtained from both nostrils. Total inflammatory cell count (TCC) in each nasal lavage was then calculated in a Neubauer's chamber.
Initial CPAP treatment caused a statistically significant rise of TCC in nasal lavage of SAS patients, when compared with initial values [n*10(5)/ml] (pre: 1.30, post: 1.92, p = 0.009). No significant differences (p > 0.05) were found both in initial TCC and nasal patency values among the three studied groups.
SAS subjects present an unchanged nasal patency when compared to control subjects. Initial CPAP therapy might be responsible for evoking local nasal inflammation.

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    ABSTRACT: Obstructive sleep apnea syndrome (OSAS) has been shown to be associated to upper and lower airways inflammation. Continuous positive airway pressure (CPAP) is the elective treatment of OSAS. The aim of the present study was to assess the effect of CPAP-therapy on airway and nasal inflammation. In 13 non-smoking subjects affected by untreated OSAS and in 11 non-smoking normal volunteers, airway inflammation was detected by analyses of the induced sputum. In the OSAS group measurements were repeated after 1, 10 and 60 days of the appropriate CPAP treatment. In addition, in 12 subjects of the OSAS group, nasal inflammation was detected by the analysis of induced nasal secretions at baseline, and after 1, 10 and 60 days of CPAP treatment. OSAS patients, compared to normal controls, showed at baseline a higher percentage of neutrophils and a lower percentage of macrophages in the induced sputum. One, 10 and 60 days of appropriate CPAP-therapy did not change the cellular profile of the induced sputum. In addition, in the OSAS patients, the high neutrophilic nasal inflammation present under baseline conditions was not significantly modified by CPAP-therapy. Finally, no patients developed airway hyper-responsiveness after CPAP therapy. In OSAS subjects, the appropriate CPAP-therapy, while correcting the oxygen desaturation, does not modify the bronchial and nasal inflammatory profile.
    Rhinology 06/2011; 49(2):232-7. · 2.78 Impact Factor

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